The principal objective of the Geisinger Clinical Oncology Program is to enroll a maximum number of participants onto NCI-approved cancer prevention, cancer control and cancer treatment protocols, and bringing research-quality cancer care to a large rural population of Pennsylvania. The Geisinger Health System (GHS) serves more than 2.5 million Pennsylvanians across 31 primarily rural counties in the central and northeastern parts of the State. This Health system includes a 556 physician primary and multispecialty group practice in 45 sites, anchored by three hubs: the 388 bed tertiary care Geisinger Medical Center in Danville, the 177 bed- hospital with 100-member multispecialty group in Wilkes-Barre and the 90-member multispecialty group in State College. New additions to the System over the past year include a 206 bed acute care hospital in Wilkes-Barre (Geisinger South Wilkes-Barre) and a large private oncology practice in Hazelton that our System acquired in June, 2007. Geisinger operates a health insurance provider with HMO and PPO products with 205,000 members that is research friendly and promotes cancer control and prevention activities. Geisinger's advantages include a strong, stable CCOP organization and staff with excellent retention, successful performance and high data quality over 24 years CCOP experience. GHS enjoys a large network of primary care practices, with all practices and all physicians (including hospital based specialists) linked by a totally paperless electronic medical records (EPIC-Care). Computerized patient management includes a System-wide IMPAC system for all chemotherapy and radiation therapy treatments, a System cancer registry (ONCOLOG) and a Protonet data management system for all cancer related clinical trials, available at all practice locations, and even to non-GHS private oncologists in our area. This CCOP proposal retains NCCTG as our primary research base, ECOG and RTOG as secondary bases, COG as our Children's base, and Fox Chase Cancer Center as a cancer prevention and control base. The relevance of this proposal to public health is that it ensures an otherwise large, rural underserved population the benefits of clinical trial participation, which has been shown to be associated with higher quality, more up-to-date cancer care. It provides a wide footprint of participation by community oncologists and helps to accelerate knowledge transfer resulting from clinical trials to our rural patients.